Lenalidomide and rituximab in Waldenstrom's macroglobulinemia. Beta-2 microglobulin is elevated in proportion to tumor mass. The differential diagnosis with other lymphomas is essential for the assessment of prognosis and therapeutic approach. Repeat 21 day cycle for 4 cycles. Paradoxical increases in serum IgM and viscosity levels following rituximab in Waldenstrom's macroglobulinemia.
|Date Added:||27 December 2007|
|File Size:||55.3 Mb|
|Operating Systems:||Windows NT/2000/XP/2003/2003/7/8/10 MacOS 10/X|
|Price:||Free* [*Free Regsitration Required]|
There is no single accepted treatment for WM. Plasma viscosity must be measured. Int J Surg Pathol.
It is fundamental to distinguish WM from other disorders that could be clinically confused with this disease. Differential diagnosis of other malignancies of B-lymphocytes secreting monoclonal IgM. Response assessment in Waldenstrom macroglobulinaemia: Another study showed the possibility of isotype switching occurring in vivo.
Guideline for diagnosis and treatment of Waldenstrom's macroglobulinaemia. Recently, autologous bone marrow transplantation has been added to the available treatment options.
Other factors may contribute to its aggravation, such as gastrointestinal bleeding, hyperhemolysis, and hyperviscosity itself, which may cause a decrease in the erythropoietin synthesis. Orellana J, Friedman AH. Other immunophenotypic characteristics of neoplastic B-lymphocytes: Cancer Management and Research. Patients experience pain, the sensation of "electric shocks" and thermal sensitivity in the lower limbs. This is absolutely necessary, particularly before starting a rituximab-containing regimen, as rituximab is known to cause a flare reaction in patients with WM-associated hyperviscosity.
Waldenström's macroglobulinemia - a review
The main reasons for choosing this regimen in these patients are the good treatment tolerance, reduced myelosuppression and waldensrtom lack of toxicity for stem cells. Neuropathies associated with paraproteinemia. In primary or light chain amyloidosis AL amyloidosisamyloid fibrils may be deposited in the heart, kidneys, liver, lungs and peripheral nerves.
Immunophenotypic variations may occur. WM was first described by Jan G. When interpreting the results it is important to consider that some parameters could be altered because the monoclonal IgM may interfere in several measurements performed in automated analyzers, especially in the evaluation of HDL cholesterol, bilirubin, inorganic phosphate, LDL cholesterol, C-reactive protein, creatinine, enferemdad, urea, iron and calcium ions.
The concentration of monoclonal IgM is one of the parameters most commonly used among the criteria for assessing response to treatment. Cutaneous lymphoid hyperplasia with bandlike and perivascular patterns with nodular pattern Jessner lymphocytic infiltrate enfeermedad the skin.
Waldenstrom Macroglobulinemia Treatment Protocols
Because of its indolent nature, many patients are able to lead active lives, and when treatment is required, may experience years of symptom-free remission. The connection to the CD20 receptor on B-lymphocytes activates the complement cascade, leading to the formation of the membrane attack complex that induces cell lysis.
Complications such as hyperviscosity syndrome, symptomatic sensorimotor peripheral neuropathy, systemic amyloidosiskidney failureor symptomatic cryoglobulinemia were also suggested as indications for therapy.
Clin Lymphoma Myeloma Leuk. Sections Waldenstrom Macroglobulinemia Treatment Protocols. Their miRNA signature however differs from their normal counterpart. Lenalidomide and rituximab in Waldenstrom's macroglobulinemia.
Waldenstrom Macroglobulinemia Treatment Protocols: Treatment Protocols
D ICD - International prognostic scoring system for Waldenstrom macroglobulinemia. Prothrombin timeactivated partial thromboplastin timethrombin timeand fibrinogen tests should be performed. Plasma exchange is an accepted treatment approach for hyperviscosity but should be considered a temporizing measure until systemic chemotherapy can be started and successfully lowers the tumor mass and the IgM level.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. While allogeneic transplantation has resulted in some very durable remissions, transplant-related mortality remains very high.
Share Email Print Feedback Close.